Time breeds perspective if you stare at something long enough. I’ve been staring at the medical device industry since 1999. At that time, the first “trend” I observed was the industry reacting to the threat of Y2K. (I’d venture to guess there’s a younger portion of the readership who may not even be all that familiar with the concept.) Since then, I’ve seen many trends emerge and fade within this always exciting, transformative industry.

Helping to generate the Top 10 company reports (that start in this issue on page 26) with fellow editors Michael Barbella and Sam Brusco, offers a unique perspective on the orthopedic technologies industry I hadn’t been privy to in years prior. Taking my first crack at the Top 10 (along with MPO’s Top 30) last year, I suffered a bit from being overwhelmed by the sheer size of the project. It was without a doubt the largest, most comprehensive editorial task I had undertaken up until that time (given the time period in which it is accomplished).

This year, I had the benefit of perspective. I had a much better understanding of what I was getting into at the start of the project. I had the prior year’s information having written or read every single report. The perspective gained from being part of the development of the Top 10 two years in a row, without a doubt, provides yet another unique perspective.

Revisiting my Editor’s Letter from this issue’s 2016 counterpart, I reviewed the trends that were called out for that year. And as the saying goes, the more things change, the more they stay the same. I suppose given only a 12-month difference, I shouldn’t expect too dramatic of change, but in that Letter, I noted that the most obvious trend was in mergers and acquisitions. In that respect, the reports this year offer more of the same, although the players have changed. The Top 10 companies spent the year making purchases of other industry firms to introduce new technologies to their product portfolio, enjoy market access and distribution into new regions, and/or increase market share in a particular clinical area. While the year lacked a mega-merger the likes of Zimmer Biomet, strategic acquisitions are a part of virtually every company report while some also include divestitures of slower performing units or those that weren’t considered core businesses by the medical device OEM.

Another trend that was revealed in last year’s reports was the shift companies were making to address the change in reimbursement models. With a fee-for-value model continuing to gain traction in healthcare and the prominence of bundled payments within the industry, orthopedic device manufacturers are enhancing services and offerings to ultimately gain access to a greater slice of the reimbursement pie. Different companies are taking their own unique strategies to achieve that goal, but universally, the shifting payment model in healthcare is a factor that all device manufacturers should be addressing within their business plan. Fortunately, the end result is very likely to be a greater focus on patient care and truly ensuring the long-term success of the treatment one receives.

The global market view that was also mentioned last year in my Letter is most certainly still a trend—perhaps even more so in the orthopedic sector where most sales are occurring within the U.S. Tenth on the list, Globus Medical specifically addressed new international market access with its particular acquisition. Gaining new customers in a region of the world that a firm is not currently serving is a fantastic strategy for increasing those sales figures for the 2018 ODT Top 10 reports. Further, acquiring a company already doing business in that region provides a much easier path to market rather than attempting to gain share organically as a new name in the area. Existing customers don’t necessarily care who ultimately is behind the familiar name of their product of choice (so long as it maintains the quality and reputation it had to gain their trust and loyalty in the first place; a fact I hope all members of the industry remember).

Another trend highlighted in last year’s Letter was the research and development strategies between medical device OEMs and universities. Similar to last year, not much of this news made it into the reports themselves, but I know in researching several of the company reports I wrote, I found agreements being mentioned with a number of institutions for the purpose of developing new technologies. I am a huge proponent of this type of strategy, as the arrangement is certainly beneficial to both sides of the agreement. I hope to hear even more about these types of pairings between academia and the industry.

It is my hope that this issue provides you with some perspective on the orthopedic technology landscape, the changes that are occurring, and where we’re headed. Enjoy!

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